SinikRN101

Personal protection is required by the agency, I keep a stash on me unless I know the patient is stocked up. Outside of that, it depends on you, if you're that uncomfortable and don't need the shift just inform the agency. Some patients homes are cluttered, but I once had to refuse to return to a case because of roaches.

I've seen ABT as short for antibiotic therapy as in documentation on adverse side effects (ase), lack thereof or therapeutic effects.

My suggestion after acls/pals would be to look for a critical care class in your area. Definitely get all the hands on you can with the more complicated cases more experience= increased competencies. Add everything to your resume and apply, apply and apply. PDN has a tendency to go stagnant/stable with repetitive scheduling, make sure you are requesting more skills and more complicated cases frequently.

I also have a lot of those things going on right now. When I attempted to educate parents on the correct uses of medication and advocate for my patient then I'm not "doing things the way they like it" and there are "personality conflicts". Personally, I'm sick of it and will be leaving asap! Very sad state of nursing.

I've recently learned how to "guide" a conversation sorta speak to find ways to avoid such things. But yes, lesson learned the hard way as I had my hours cut because I was in school, in the future I will lie.

Walk in, greet parent(s)/caregiver full assessment, full set of vitals- assessment and vitals will dictate any priority intervention. Check if patient needs changed/turned/ toileted. Am/Pm cares, oral care, washing face , bed bath etc. Check and give any scheduled medications and proceed with plan of care/485. Each patient usually has a rountine and you can usually set up your own especially if you are a creature of habits and routines. I usually bring something to do in between and during down time like a handheld game or something that won't make me sleepy because I work nights... Obviously. Before the end of the shift document, clean all equipment, set up for next shift and be ready to give report. My example of PDN.

Look into getting your record expunged. Any rehabilitation efforts in addition to the time that has passed would help also. Usually the biggest hurdle is the state board seems like if they granted your license I don't know why an individual employer wouldn't look past your record, unless it's a state or federal job. They won't hire anyone with a record...period.

Do which ever works for you. I usually prefer to go home and go straight to sleep to be awake with my kiddos in the afternoon (after school) and early evening and even tuck them in before I go to work. But for certain things like appts, or special occasions like going out to breakfast on Father's day or something I'll stay awake and sleep later on. That's the beauty of working nights. On your days off I would say it depends on you. If you don't find it hard switching back and forth go for it. I've done both.

Yes on the consistent schedule. The only person that can change the schedule would be a Doctor's order. Check with your nurse practice act and/or state board. Ours states that we have one hour before and up to one hour after. IE) Order states to give at 2100, we can give it beginning at 2000, or up to 2200, after that it is considered a med error for missing one of the 5 rights. Patient, med, time, dose, route... etc. Also, the unique challenge of PDN, is you can check the BP all you want and if you miss the time, then the parent can decide they want to give the med. At that point all you can do is document in the nurse's notes "mom gave propanolol at this time" and inform the next nurse in report (if there is one). Hope this helps.

When in a situation of mandatory reporting as nurses are it's not an option to report, hence "mandatory reporter". You can tell them (if you so choose) that you need to report because you are a mandatory reporter, if they choose not to have you back that is up to them, emphasize on the fact that they need additional help to care for all the children involved and especially the patient. What happens after you send in the report is up to them(CPS), not you. They can do something, or do nothing, but you've done the part you needed to. You can be charged with a crime for knowing something is going on and not reporting. When reporting, make sure everything is objective.. I saw ______ on ___date. Report only the facts and nothing subjective. If you really feel awkward and do not want to go back that is understandable and should be communicated with the agency. Really crumby that they don't care about the patient/ only the $$$.

I used to be able to flip back and forth. After 4-5 years, it's much easier to stay up during my nights off and continue my regular schedule even on my days off. Sometimes I end up watching tv by myself while the family sleeps, but I tell myself it won't be forever as I am going back to school, I use the time off and down time at work to work on homework. :)

Yes, the lack of professionalism is appalling. They expect us to act like professionals, I expect to be treated as such ie) regulating how much time is needed to sit at a desk and chart and how much is needed at the bedside. And to one of the previous posts whose answer to the pregnant nurse who didn't get any breaks was to "just quit then". What world do you live in without bills to pay? I want to go there. Over here, I have kids to feed and bills to pay, so "just quitting isn't always an option, especially if I were 8 months pregnant and about to have a baby.

I've had the same thing happen to me, I know the feeling. It also creates a very sour work environment. It seems sometimes they are never happy and I've been chalking it up to trying to deal with the loss of the image they had before "the event" whatever it may be that happened to their child. I also felt very betrayed and now am being added to another case so maybe I have one foot out the door and one still in. A 90 minute drive is pretty far, not sure if I wouldn't start a new job, but yeah being pregnant I think they have you in a catch 22. They know you can't get fmla at another job.

Yes I agree. Tasteful, tattoos shouldn't be a problem. Now the letters that are vulgar on the fingers, distasteful things I would probably have a problem with. My patients have asked me about my tattoo, but I haven't had anyone who's had a problem with it.

Thank you to the OP for posting this and getting completely flamed and standing your ground. I know I'm not alone, but I usually can not come up with the right words and certainly not as articulate as you have posted. Currently, I have the learned the hard lesson (among others) that if you give a mouse a cookie.... which is why (for the time being) going above and beyond is not in my current or future plans.

I know the feeling, but in my own mind... I didn't go to clown college. Although I'm sure it would have been a lot less expensive. I would have told them well if you promised to do it... be my guest (okay probably not, but I would have thought it!). Realistically 12 hours is a lot on the voice and sounds really absurd to me. Like as suggested if the parents have so much time to be watching you every second, why don't they read to the kid? I agree with the looking elsewhere because this sounds drastically miserable.

The way I see it, was you chose not to deal with it. While you admit that was your mistake, maybe in the future realize the fatigue is not worth the extra hours and burnout. While working in LTC, there was 2 LVN's and 1 RN for the entire building for night shift. Whenever I could not physically take care of it myself I would ask the RN for help, who would be so gracious and help out. Been there done that, if something is on you, you have to take care of it, even if you have to stay after shift to finish up after you've given report. When they complain about overtime (and they will) tell them you didn't have time do to xyz and keep a log.

You are already know you're not like your neighbor I think somewhere deep down inside. Just like you, I got pregnant at as a teen 18 (but still a teen) I've been working and going to school off and on ever since. I lived with my parents while I got my LVN and moved out soon after. I then stopped going to school to help take care of my dying mother, now I am back in school finishing my pre-reqs to apply to the RN program next month all while working full time to support my family and my husband who is also in school. Keep your pace, you already know where you are going and your path is nothing like hers.

I understand when they have a "special speaker" or something and it's mandatory and they can't schedule another time, however, they should at least try to give you the day off. If not, I would call off. I used to work for a facility that did this frequently, night shift was expected to be at "mandatory" meetings, however if someone from night shift just simply wasn't there, they didn't write us up for it. Now I work for a facility that has 2 meetings per month, one in the early AM and late PM so that everyone can attend one or the other.

I have only heard of two patients = two nurses. A friend of mine told me about a situation where she was in need of feminine products and went to the corner market and came back and was fired from it as it was abandoning the patient even though one nurse was present for both patients because she worked with another nurse. I would definitely ask to be oriented to these patients by shadowing another nurse. It really helps with anything you might run into as well as locating supplies, routines, preferences, medications etc. I'm not sure I would sit in a living room, maybe go in there to do some charting but ask for a chair in one room or the other, and make several room checks. I know how scary the thought of aspiration is, maybe use that to create more due diligence? Like if they were hospital rooms you couldn't keep an eye on them every second. Remember to elevate the HOB and chart to CYB.

I work full time, per diem. usually 4-5/ 8 hr. Noc shifts. Usually all on one pt. If my patient is admitted they scramble to catch me a couple of days. I think it usually just depends on what they have available at any given time, when you are hired, new patients coming on services or off.

I work per diem and had to sign that I would work 4 weekend shifts per month, in the beginning that was fine since we used to get weekend differential, but since they took it away there's no incentive. If I specifically ask for a weekend off I only get 3 shifts for the week because I get 2 weekdays off also in addition to the weekend. I really wish they'd make a rotating schedule because some nurses are expected to work every weekend and other nurses get every weekend off.

I get that there are some nurses who try to please people and do more of the "customer service" role. But this is ridiculous I went to school for Nursing not customer service. If I wanted to kiss behind all day I would have picked a different career. I'm there to do my job and nothing more and nothing less. Not only that, who knows if what they put online is true, sounds like a good way to open up libel to me.

Coming from personal experience if the supervisor doesn't catch these things obviously they don't care. You telling/informing them isn't going to make one bit of difference until it comes time for state inspection. At least that was my experience, I could talk until I was blue in the face and all it did was make it seem like I was the problem. Luckily I didn't have anything that was dangerous, only completely annoying.

My best advice would be to ask for a patient who can sprint off the vent for at least a few minutes at a time to get comfortable with the vent/trach/suction equipment and alarms to learn what they mean. Next I would know at all times where the back up trach tray is, the bvm, the suction machine and anything other essential equipment and keep it within arms reach. On top of that, get a good full report and don't be afraid to ask questions. You already sound like a diligent nurse so that is a plus, and remember to trust your instincts if something doesn't seem right don't second guess yourself. Best of luck!